Nicole Alyssa Pellicciotto, MED, ABD

NPI #1720200728 in Fairfax, Virginia

Provider Information

NPI Number: 1720200728
Entity Type: Individual
Name: Nicole Alyssa Pellicciotto, MED, ABD
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Developmental Therapist
Credential: MED, ABD
Enumeration Date: May 2, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 11642 LEEHIGH DRIVE
City: Fairfax
State: Virginia
ZIP Code: 22030-5640
Phone: (703) 819-4697

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Developmental Therapist	222Q00000X	Primary

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